http://gradworks.umi.com/34/63/3463273.html
Abstract:
Stroke is one of the leading causes of serious long-term disability in the United States. According to statistics from 1996, the American Occupational Therapy Association reported that clients following stroke are the single largest population seen by occupational therapists in their practice. Furthermore, motor impairment of the upper extremity is one of the most common of the stroke sequelae. There is a call within the profession of occupational therapy to improve the use of evidence-based practice amongst clinicians in all areas of practice including stroke rehabilitation. In order to assure that occupational therapy services being delivered are appropriate, effective, and efficient, outcomes research related to best practice interventions need to be established. However, multiple barriers have been identified which impede effective research utilization. This doctoral project sought to identify, analyze and synthesize the current evidence related to occupational therapy interventions, which address motor impairments of the upper extremity in clients following stroke The comprehensive literature review was used to establish best practice guidelines for occupational therapists working in stroke rehabilitation. The suggested program established as part of this doctoral project consisted of a comprehensive training module for occupational therapists based on adult learning theory; implementation of a standardized motor assessment to be used to guide evaluation and treatment of clients and to later assist with program evaluation; and a decision-tree to assist therapists with identifying the most appropriate intervention to be implemented with each client. These efforts will address some of the barriers identified in establishing evidence-based practice with the primary objective being to improve client outcomes and quality of life following stroke
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